Optimal Repair Research Articles

Less postoperative pain and shorter length of stay after robot-assisted retrorectus hernia repair (rRetrorectus) compared with laparoscopic intraperitoneal onlay mesh repair (IPOM) for small or medium-sized ventral hernias.

The optimal repair of ventral hernia remains unknown. We aimed to evaluate the results after robotic-assisted laparoscopic transabdominal repair with retrorectus mesh placement (rRetrorectus) compared with laparoscopic intraperitoneal onlay mesh repair (IPOM) for patients with small- or medium-sized ventral hernia. This was a retrospective cohort study of consecutive patients undergoing elective rRetrorectus or IPOM repair for small or medium-sized primary ventral or incisional hernias. The primary outcome was the postoperative need for transverse abdominis plane (TAP) block or epidural analgesia, secondary outcomes were length of stay and postoperative complications. All patients were followed for 30days postoperatively. A total of 59 patients were included undergoing rRetrorectus (n = 27) and IPOM (n = 32). Patients in the two groups were comparable in terms of age, sex, comorbidities, smoking status, body mass index (BMI), and type of hernia. The median fascial defect area was slightly larger in the rRetrorectus group (9 cm2 vs. 6.2 cm2, P = 0.031). The duration of surgery was longer for rRetrorectus (median 117.2min. vs. 84.4, P = 0.003), whereas the postoperative need for TAP block or epidural analgesia was less after rRetrorectus compared with IPOM (3.7% versus 43.7%, P = 0.002). There were no severe complications or reoperations after either procedure. The length of stay was shorter after rRetrorectus (median 0 vs. 1day, P < 0.001). rRetrorectus was associated with reduced postoperative analgesic requirement and shorter length of stay compared with laparoscopic IPOM. Registration Clinicaltrial.gov: NCT05320055.

Postpartum Dyspareunia Following Continuous Versus Interrupted Perineal Repair: A Systematic Review and Meta-Analysis.

Research evaluating optimal repair techniques for the reduction of postpartum dyspareunia following obstetric laceration is severely limited. Prevailing guidelines from the American College of Obstetricians and Gynecologists (ACOG) are reliant on data from just nine clinical trials conducted from 1980 to 2012. While the literature on this topic is still limited today, this review aims to synthesize data from past and present studies to ensure that standing clinical recommendations are supported by current literature.A review was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Medical Literature Analysis and Retrieval System Online (MEDLINE), Cochrane Library, and Google Scholar were searched. Included articles (1) compared continuous with interrupted repair techniques for subjects with episiotomies and/or second-degree tears, (2) were available in full length, and (3) reported dyspareunia as an outcome variable. Excluded articles were those (1) inclusive of first-, third-, or fourth-degree tears; (2) comparing suture material rather than technique; and (3) not available in English. A meta-analysis was conducted for both acute dyspareunia (<3 months) and chronic dyspareunia (>3 months) utilizing Meta-Essentials Microsoft Excel (Microsoft Corp., Redmond, WA) workbook. Bias was evaluated via Egger regression and Begg and Mazumdar rank correlation tests.Twelve articles met inclusion and exclusion guidelines, seven for acute dyspareunia and eight for chronic dyspareunia. All publications were randomized controlled trials and were inclusive of a total of 4,081 patients. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random effect model. Analysis revealed no statistically significant difference between continuous and interrupted suture groups for acute dyspareunia (RR: 0.98; 95% CI: 0.89-1.08) or chronic dyspareunia (RR: 0.96; 95% CI: 0.83-1.12). Egger regression test (p-value=0.534) and Begg and Mazumdar rank correlation test (p-value=0.570) indicated minimal publication bias. Compiled data does not indicate a preferential suture technique for the reduction of postpartum dyspareunia. These findings are congruent with the ACOG guidelines; therefore, there is no supporting evidence for ACOG's recommendation of continuous suturing to be overturned.

Torsional repair of damaged single-box multi-cell composite box-girder with corrugated steel webs using CFRP. Part II: Theoretical investigation

Due to their low torsional stiffness, Single-Box Multi-Cell Composite Box-Girders with Corrugated Steel Webs (SBMC-CBGCSWs) under eccentric load are more prone to fail when compared to traditional concrete structures, leading to the increased probability of the need of repair during their life span. To avoid secondary failures and provide a theoretical basis for the evaluation of the optimal repair scheme, a rational rotating-angle model is proposed in this paper to predict the torsional response of damaged SBMC-CBGCSWs repaired with FRP. This proposed model primarily incorporates the effect of FRP on the damaged concrete and proposes constitutive models for the FRP-repaired concrete. At the same time, the effective thickness of shear flow zone for concrete slabs is considered, and the three-stage average stress–strain relationships for concrete struts are proposed for this model. Besides, a new shear strain relationship between inner and outside Corrugated Steel Webs (CSWs) is adopted to estimate the torsional behavior of inner CSWs in SBMC-CBGCSW. The comparison of theoretical predictions and experimental results presented in the companion paper in terms of torque-twist curves, key points, and strains in FRP strips, concrete slabs and CSWs indicates that the proposed model can accurately predict the entire nonlinear behavior of the damaged SBMC-CBGCSWs repaired using CFRP. The parametric study carried out by this proposed model shows that the ultimate strength of CFRP-repaired SBMC-CBGCSWs is approximately linear with the damage coefficient of concrete and the CFRP ratio. In addition, it is found that the effective thickness of shear flow zone and the three-stage average stress–strain relationships for concrete struts adopted in this model can produce reliable predictions of cracking and ultimate torques.

Quantitative model for residual bearing capacity of corroded reinforced concrete pipe based on failure mode

Reinforced concrete pipes (RCPs) are widely used as jacking pipes in various infrastructures, such as sewers, tunnels, and pipe galleries. However, owing to the presence of harmful chemicals and microorganisms in the surrounding environment, the pipe gradually corrodes, thereby thinning the pipe wall and lowering the residual bearing capacity (RBC) of the structure. For the daily maintenance of the RCP, the RBC should be evaluated precisely to ascertain the service status of the pipe, and if necessary, timely rehabilitation can be performed to yield the optimal repair outcome and cost efficiency. In this study, quantitative models for RBCs of both intact and corroded RCPs are proposed; these models are based on the plastic collapse failure mode of rigid pipe. Additionally, the impact of uncoordinated deflection between concrete and reinforcement has also been characterised. A series of numerical simulations were developed on the basis of the finite element method (FEM) to evaluate the RBC of corroded RCPs, and the FEM results are consistent with those of the quantitative model. Finally, three-edge bearing (TEB) tests were conducted by incorporating both intact and corroded RCPs. The results of the TEB tests also revealed the reliability of the quantitative model.

Arthroscopic Techniques to Stabilize Glenoid Bony Bankart Fragments

A bony Bankart lesion is an avulsion of the labroligamentous complex associated with an anterior glenoid rim fracture. Bony Bankart lesions can be seen in up to 70% of traumatic shoulder dislocations. With such a high prevalence, the development of an optimal repair technique is important. Selection of the most appropriate repair method depends heavily on the individual hard- and soft-tissue characteristics of the presenting lesion, as well as surgeon experience with the various repair options. We describe 3 arthroscopic Bankart fixation techniques (labrum alone, transosseous, and double row) to address a range of presenting Bankart pathologies.

Optimal Repair Rate for a Repairable Machine with Nonlinear State Equation

This work deals with two models of a single machine subject to breakdowns. The first model is a binary-state model while the second one is a multi-state model. Breakdowns are followed by repairs. The systems under study are of the tracking type. We use nonlinear model predictive control to determine the optimal repair rates that keep the variables as close as possible to their target. Numerical illustrations with sensitivity analysis are used to assess the effect of the system parameters on the optimal solution.

Aortic Valve Repair in Neonates With Aortic Stenosis and Reduced Left Ventricular Function

This study assessed outcomes of neonatal aortic valve (AoV) repair in presumed high-risk patients with depressed left ventricular (LV) function. A retrospective analysis of all neonates who underwent isolated AoV repair for severe aortic stenosis (AS) was performed. Patients with moderate or severe LV dysfunction were compared to those with normal or mild LV dysfunction. From 1980-2021, 43 neonates underwent isolated AoV repair for AS. Of these, 16 patients (37.2%) had ≥moderate LV dysfunction. Mean LV ejection fraction (EF) was 32.8 ± 9.1%. Valve morphology was mostly unicuspid (68.75%, 11/16). Median age at surgery was 6.5 days (IQR 1-17.5). An optimal repair result with ≤mild AS or aortic regurgitation was achieved in 75% (12/16). There was no early death. One patient (6.25%) required postoperative extracorporeal membrane oxygenation (ECMO) support for 3 days. LVEF improved after surgery to 56.4 ± 12.6% before discharge (P < 0.0001) and normalized in 87.5% (14/16) with a median time of 6.4 days (IQR 3.4-39). Freedom from AoV reoperation was 45.1% (95%CI 17.9-69.3%) and 27.1% (95%CI 6.8-53%) at 5 and 10 years, respectively. Freedom from AoV replacement was 59% (95%CI 27-80.8%) and 31.4% (95%CI 6-62.2%) at 5 and 10 years, respectively. While survival was similar, freedom from AoV reoperation and replacement tended to be lower compared to neonates with preserved LVEF. AoV repair was associated with a low incidence of postoperative ECMO and mortality. LV function normalized after relief of obstruction in most patients before discharge. Late reoperation remained common for those with severely dysplastic valves.

Optimization repair And Maintenance Method of Aircraft Ground Support Systems at Islamic Republic of Iran Army Airforce.

Optimization repair And Maintenance Method of Aircraft Ground Support Systems at Islamic Republic of Iran Army Airforce.

Multibank Optimized Redundancy Analysis Using Efficient Fault Collection

With technological advancements, the density and capacity of memory are rapidly increasing. As the number of memory cells increases, the difficulty of fault analysis and the number of faults also increase. Hence, the yield and test cost of memory have become essential issues in memory manufacturing. Many manufacturers have used redundancy analysis (RA) to improve the memory yield and decrease the test cost. However, most conventional RA methods require a lengthy analysis time to find a repair solution, and it is difficult to obtain an optimal repair rate with conventional RA algorithms. Although several algorithms using various spare structures to achieve performance improvement have been proposed, those improvements have not been ground breaking. In this article, a new multibank optimized RA (MORA) algorithm is proposed. It achieves a very high repair rate and a drastic reduction in the analysis time compared with conventional RA algorithms using various spare structures. During testing, the proposed algorithm stores the faulty cell information efficiently. Therefore, the analysis time can be shortened through the presolution process of the repair analysis using the proposed fault storage spaces. Additionally, the proposed spare structures are used to increase the repair rate. The experimental results reveal that the proposed algorithm can achieve a very high repair rate at a faster speed than conventional RA algorithms.

Nonlinear Repair of Reed-Solomon Codes

The problem of repairing linear codes and, in particular, Reed Solomon (RS) codes has attracted a lot of attention in recent years due to their extreme importance to distributed storage systems. In this problem, a failed code symbol (node) needs to be repaired by downloading as little information as possible from a subset of the remaining nodes. By now, there are examples of RS codes that have efficient repair schemes, and some even attain the cut-set bound. However, these schemes fall short in several aspects; they require a considerable field extension degree. They do not provide any nontrivial repair scheme over prime fields. Lastly, they are all linear repairs, i.e., the computed functions are linear over the base field. Motivated by these and by a question raised by Guruswami and Wootters, 2017, on the power of nonlinear repair schemes, we study the problem of nonlinear repair schemes of RS codes. Our main results are the first nonlinear repair scheme of RS codes with asymptotically optimal repair bandwidth (asymptotically matching the cut-set bound). This is the first example of a nonlinear repair scheme of any code and also the first example that a nonlinear repair scheme can outperform all linear ones. Lastly, we show that the cut-set bound for RS codes is not tight over prime fields by proving a tighter bound, using additive combinatorics ideas.

Aortic Remodeling After Stepwise External Wrapping for Type A Acute Aortic Dissection

BackgroundThe optimal repair technique for type A acute aortic dissection is graft replacement; however, the treatment approach in high-risk patients remains controversial or suboptimal. MethodsWe have retrospectively analyzed a cohort of high-risk patients who were admitted to our center for type A acute aortic dissection and who were treated by a new surgical approach using artificial grafts (stepwise external wrapping) between January 2016 and January 2020. The primary endpoints included inhospital mortality and survival during follow-up. Secondary endpoints included the assessment of aortic remodeling after ascending aorta wrapping. ResultsAmong the 134 patients admitted for type A acute aortic dissection, 43 patients underwent stepwise external wrapping. The mean patient age was 79.1 ± 6.8 years. The new standard European System for Cardiac Operative Risk Evaluation score was 64% ± 12%. There was one hospital death (2.3%). There were two major complications of persistent cerebral disorder (4.6%). Minor complications included temporary neurologic disorder (2.3%) and renal failure (2.3%). The intensive care unit and hospital stays were 2.8 ± 1.0 days and 11.7 ± 2.5 days, respectively. The follow-up survival rate was 95.3% ± 6.2% and 91% ± 10.2% at 1 and 3 years, respectively, after surgery. There was no aortic-related death during follow-up. At 1 year after surgery, complete remodeling of the ascending aorta was obtained in 30 patients (85.7%), and 5 patients (14.3%) showed partial remodeling. ConclusionsOur stepwise external wrapping technique was associated with excellent outcomes for high-risk patients with type A acute aortic dissection.

Microglia coordinate cellular interactions during spinal cord repair in mice

Traumatic spinal cord injury (SCI) triggers a neuro-inflammatory response dominated by tissue-resident microglia and monocyte derived macrophages (MDMs). Since activated microglia and MDMs are morphologically identical and express similar phenotypic markers in vivo, identifying injury responses specifically coordinated by microglia has historically been challenging. Here, we pharmacologically depleted microglia and use anatomical, histopathological, tract tracing, bulk and single cell RNA sequencing to reveal the cellular and molecular responses to SCI controlled by microglia. We show that microglia are vital for SCI recovery and coordinate injury responses in CNS-resident glia and infiltrating leukocytes. Depleting microglia exacerbates tissue damage and worsens functional recovery. Conversely, restoring select microglia-dependent signaling axes, identified through sequencing data, in microglia depleted mice prevents secondary damage and promotes recovery. Additional bioinformatics analyses reveal that optimal repair after SCI might be achieved by co-opting key ligand-receptor interactions between microglia, astrocytes and MDMs.

How to Manage the Pulmonary Valve During Repair of Tetralogy of Fallot

Evolution of Pulmonary Valve Management During Repair of Tetralogy of Fallot: A 14-year ExperienceThe Annals of Thoracic SurgeryPreviewThe optimal repair strategy for tetralogy of Fallot remains controversial. This report presents a 14-year evolution of management of the pulmonary valve (PV) from transannular patch to valve-sparing repair to neovalve creation using living right atrial appendage tissue. Full-Text PDF

Assessment of postoperative cosmetic outcomes of distal form hypospadias repair with the Hypospadias Objective Scoring Evaluation (HOSE).

Aim A standardized assessment for the optimal repair of hypospadias remains elusive. The aim of this study was to assess a postoperative cosmetic outcome of hypospadias repair using a validated questionnaire, Hypospadias Objective Scoring Evaluation (HOSE). Methods During the period between January 2016 and May 2019, 40 patients who underwent hypospadias repair were identified and they agreed to a follow-up using the HOSE. Distal hypospadias repairs underwent a cross-sectional assessment of the cosmetic outcome. Cosmetic assessment was performed by an independent physician using the HOSE scoring system. Results The native meatus was coronal in 10 (25%), subcoronal in eight (20%), and distal penile in 22 (55%) patients. Mean followup was 35.90 months (SD ±29.58) postoperatively (range 12-162 months). Complications occurred in one (2.5%) patient. Out of 40 uncomplicated repairs, 39 (97.5%) were satisfactory. A vertical slit-like meatus located at the distal glans was created in 33 (82.5%) boys, and at the proximal glans in seven (17.5%). The urinary stream was single and straight in 39 and spray in one patient. A straight erection was observed in 39 (97.5%) boys. The median HOSE score was 16 (range 12-16). One patient had a small, single coronal fistula. The technique used included tubularised incised plate urethroplasty. Conclusion The HOSE score is simple, easy, non-invasive and non-expensive tool for objective assessment of long-term outcomes of hypospadias repair.

Resilience Evaluation and Enhancement for Island City Integrated Energy Systems

Extreme natural hazards, such as hurricanes or earthquakes, have a high probability of threatening energy supply security and causing high-order contingencies to island city-integrated energy systems (IC-IESs). To better evaluate and enhance resilience, a novel approach is proposed in this work for IC-IESs. The resilience of an IC-IES is analyzed from both the system level and the component level. At the system level, the impacts of extreme natural disasters are quantified. At the component level, the importance of individual components is analyzed through pre-failure and post-failure indices. The pre-failure index identifies the system’s weak links before an energy interruption, and the post-failure index determines the optimal repair strategy to restore the service. The proposed indices are solved by the impact increment method (IIM), which significantly improves computational efficiency without much affecting result accuracy. Numerical simulation studies are conducted on the modified Barry Island IES and IES E123-G48-H32 test systems. The results validate the effectiveness of the proposed approach.

Optimal Repair Policies for Systems Deteriorating After Disruptions

We consider a scenario where a system experiences a disruption, and the states (representing health values) of its components continue to reduce over time, unless they are acted upon by a controller. Given this dynamical setting, we consider the problem of finding an optimal control (or switching) sequence to maximize the sum of the weights of the components, whose states are brought back to the maximum value. We first provide several characteristics of the optimal policy for the general (fully heterogeneous) version of this problem. We then show that under certain conditions on the rates of repair and deterioration, we can explicitly characterize the optimal control policy as a function of the states. When the deterioration rate (when not being repaired) is larger than or equal to the repair rate, and the deterioration and repair rates as well as the weights are homogeneous across all the components, we show that the policy that targets the component with the largest state value at each time step is optimal under certain conditions. On the other hand, if the repair rates are sufficiently larger than the deterioration rates, the optimal control policy is to target the component whose state minus the deterioration rate is least in a particular subset of components at each time step.

Optimization of Renewable Warranty by Considering System Reliability and Preventive Maintenance and Repairs

One of the effective ways to ensure the reliability of the product sold is to consider service and warranty contracts. Important decision variables in warranty policies include determining the optimal warranty period and the optimal number of maintenance activities. In this research, a model has been developed with the aim of achieving the lowest expected cost rate in the life of the device and the appropriate reliability by performing the optimal number of preventive maintenance measures. The warranty policy in this study is renewable in two dimensions, in which two dimensions of repair time and failure time are considered. Any damage leading to repair is done free of charge by the manufacturer and damage leading to replacement is done jointly between the manufacturer and the consumer by agreement. As a result, two algorithms of Genetic and Imperialist Competitive Algorithm have been developed to solve the model and have been compared with numerical example solving. Furthermore, the shelfs life of the system and the number of optimal repair and maintenance measures for maintaining reliability required by the buyer were obtained.

Evolution of Pulmonary Valve Management During Repair of Tetralogy of Fallot: A 14-year Experience

BackgroundThe optimal repair strategy for tetralogy of Fallot remains controversial. This report presents a 14-year evolution of management of the pulmonary valve (PV) from transannular patch to valve-sparing repair to neovalve creation using living right atrial appendage tissue. MethodsA retrospective review of 172 consecutive patients undergoing complete repair for TOF between January 2007 and June 2021 was performed. Clinical and follow-up data were analyzed by repair group. Neopulmonary valve (NPV) creation using right atrial appendage tissue was introduced in 2019. Failure of valve-sparing repair was defined as needing reintervention for recurrent right ventricular outflow tract obstruction (RVOTO). ResultsMedian age and weight at repair were 4.9 months and 6 kg, respectively. Median preoperative PV size and z-score were 6.4 mm (5.2-8.3 mm) and −3.2 (−4.1 to −2.1), respectively. Patients who underwent valve-sparing repair had larger PV size and z-score compared with patients who underwent transannular patch procedures (8 mm vs 5.6 mm; −2.1 vs −3.2; both P < .001). There were no hospital mortalities. Overall follow-up was 44 months. At last follow-up, 10% of patients who underwent valve-sparing repair had repeat intervention for recurrent RVOTO. Patients who had failed valve-sparing repair had significantly lower PV z-scores (−2.6 vs −1.9; P = .01). An NPV was used in 8 patients with a median PV z-score of −4 (−4.7 to −3.9). At 6 months, 6 patients (75%) had mild or trivial pulmonary insufficiency after NPV placement. ConclusionsRepair of tetralogy of Fallot is a safe operation with excellent outcomes. Valve-sparing repair avoids right ventricular dilation but may fail for RVOTO at a PV z-score <−2. NPV creation offers an alternative option in patients with a small PV.

Perineal hernia repair after abdominoperineal resection (APR) with the laparoscopic-peritoneal dual fixation technique.

Perineal hernia (PH) following abdominoperineal resection (APR) is a rare but challenging problem. Although different techniques have been described in literature, the recurrence rate is still remarkable, and there is no consensus regarding the optimal repair approach. In the present study, we reported our experience based on a consecutive series of ten cases. Ten symptomatic large perineal hernias were repaired exclusively with the same laparoscopic-perineal dual fixation technique. Key steps consist laparoscopic adhesiolysis, hernia contents reduction, open excess perineal hernia sac resection, and mesh placement and dual fixation. Frist, a coated mesh was fixed to the sacrum and pelvic sidewalls with the metallic tacks in the laparoscopic step, second, the mesh was fixed anteriorly to urogenital diaphragm and laterally to the sacrotuberous ligament with permanent sutures in the perineal step. Ten symptomatic PHs were repaired by the same laparoscopic-perineal dual fixation technique, 6 males and 4 females, median age at the time of repair was 69.5years (range 66-77years), the BMI was 24 ± 1. Four concomitant procedures were performed, including bilateral inguinal hernia repair with the transabdominal preperitoneal repair (TAPP) in one case, and laparoscopic parastomal hernia repair in two patients. The average operative time was 171 ± 45min; the postoperative average hospital stay was 14 ± 4days. There was no perineal hernia recurrence during the follow-up period (the median follow-up was 42months; range 1-63months). Perineal hernia after APR is a rare and challenging postoperative complication, although many different approaches have been described, the recurrence is still high and the best method cannot be drawn. The present laparoscopic-perineal dual fixation approach proved to be a reproducible, effective and durable technique, and gave excellent results during the medium-long-term follow-up.

On Rack-Aware Cooperative Regenerating Codes and Epsilon-MSCR Codes

In distributed storage systems, cooperative regenerating codes tradeoff storage for repair bandwidth in the case of multiple node failures. In rack-aware distributed storage systems, there is no cost associated with transferring symbols within a rack. Hence, the repair bandwidth will only take into account cross-rack transfer. Rack-aware regenerating codes for the case of single node failures have been studied and their repair bandwidth tradeoff characterized. In this paper, we consider the framework of rack-aware cooperative regenerating codes for the case of multiple node failures where the node failures are uniformly distributed among a certain number of racks. We characterize the storage repair-bandwidth tradeoff as well as derive the minimum storage and minimum repair bandwidth points of the tradeoff. We also provide explicit constructions of minimum bandwidth rack-aware cooperative regenerating codes and minimum storage rack-aware cooperative regenerating codes for a large range of parameters. We also consider another extension of minimum storage cooperative regenerating codes, in which we design slightly sub-optimal cooperative regenerating codes with much lower sub-packetization. <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\epsilon $ </tex-math></inline-formula> -MSR codes are a class of codes introduced to tradeoff sub-packetization level for a slight increase in the repair bandwidth for the case of single node failures. We introduce the framework of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\epsilon $ </tex-math></inline-formula> -MSCR codes which allow for a similar tradeoff for the case of multiple node failures. We present a construction of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\epsilon $ </tex-math></inline-formula> -MSCR codes, which can recover from two node failures, by concatenating a class of MSCR codes and scalar linear codes. We give a repair procedure to repair the <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\epsilon $ </tex-math></inline-formula> -MSCR codes in the event of two node failures and calculate the repair bandwidth for the same. We characterize the increase in repair bandwidth incurred by the method in comparison with the optimal repair bandwidth. Finally, we show the subpacketization level of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\epsilon $ </tex-math></inline-formula> -MSCR codes scales logarithmically in the number of nodes.